Provider Demographics
NPI:1336512722
Name:TALWAR, MAHINDER PAL SINGH (RPSGT)
Entity Type:Individual
Prefix:
First Name:MAHINDER
Middle Name:PAL SINGH
Last Name:TALWAR
Suffix:
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-3145
Mailing Address - Country:US
Mailing Address - Phone:731-676-2894
Mailing Address - Fax:
Practice Address - Street 1:1505 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3145
Practice Address - Country:US
Practice Address - Phone:731-676-2894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21677246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other